Breast Cancer in Men – How it is Treated Effectively?

Breast cancer is commonly associated with women, however, it can also occur in men. Breast cancer can occur in men at any age, but is most commonly seen between the ages of 60 and 70. According to the American Cancer Society, 1 in 833 men are at risk of developing breast cancer. In fact, male breast cancer accounts for less than 1% of all breast cancer cases worldwide, but it is still important to be aware of male breast cancer and its symptoms. 

In men, breast cancer may show symptoms like a lump or thickening in the breast tissue, pain or discomfort in the breast area, changes in the skin on the breast, and unusual discharge from the nipple. If you notice any of these symptoms of breast cancer, seek medical attention immediately. Early detection and proper treatment can greatly increase the chances of a successful outcome.

Know more about risk factors and symptoms of Male Breast Cancer https://onco.com/blog/breast-cancer-can-affect-men-too/

How is Male Breast Cancer Treated?

Just like other cancer treatments, male breast cancer requires prompt and effective treatment. The good news is that there are several options available for treating this disease. Generally, a multidisciplinary approach is required for a personalised treatment plan to treat male breast cancer at its best. The multidisciplinary team is a panel of cancer experts from various specialisations such as surgery, medical oncology, radiation oncology, pathology, and other specialists involved depending on the case. All these experts combinedly develop a personalised treatment plan considering the type and stage of breast cancer and the patient’s overall health. 

Some of the most common treatments for male breast cancer include surgery to remove the tumour, radiation therapy, and systemic therapy such as chemotherapy, targeted therapy, or hormonal therapy. Systemic therapies enter the bloodstream and reach cancer cells throughout the body. Sometimes, a combination of therapies is recommended. Your doctor will determine the best course of treatment for you after outweighing the benefits of each treatment plan against their side effects and complications.

Local Treatments:

Surgery and certain types of radiation therapy are called local treatments. Because these treatments focus only on tumours and not on the entire body as systemic therapies do. These are primarily recommended for treating early-stage cancers or less-advanced cancers.

Surgery for Male Breast Cancer 

Surgery is the best choice for early-stage and locally-advanced breast cancer. Here, the cancer-affected part of the breast will be removed along with some surrounding healthy tissue. Different types of surgeries are there that are chosen for different reasons depending on the type of breast cancer a man is suffering with. Surgery may either be preferred to remove the tumours as much as possible or to relieve symptoms of advanced breast cancer or to know if the cancer has spread to nearby lymph nodes in the underarm region by performing a biopsy.

Types of surgical procedures for removing breast tumours in men:

Modified radical mastectomy: It is done to remove the entire breast having cancer. This includes the removal of the nipple, areola (dark-coloured skin around the nipple), the skin of the breast, and nearby lymph nodes. Mastectomy is included with two different procedures such as skin-sparing mastectomy (skin can be preserved), and nipple-sparing mastectomy (Nipple can be preserved). Your doctor will choose the best surgical option depending on your tumour size. If both breasts are affected by cancer, then surgery is done to remove both breasts. This procedure is called a double mastectomy.

Radiation therapy for Male Breast Cancer

Men with breast cancer often present with large tumours and have to undergo mastectomies. But the information on the efficacy of radiation therapy after surgery is limited and research is still going on. So, most cancer specialists are following the guidelines set for women to treat breast cancer with radiotherapy after mastectomy. Radiation therapy uses high-energy rays to destroy cancer cells or tumours. After surgery, it is recommended to destroy any left-over cancer cells.  

Systemic Treatments:

Chemotherapy for Male Breast Cancer

Chemotherapy uses powerful anti-cancer medicines to destroy or slow the growth of cancer cells. It is recommended for breast cancer that has spread to distant parts of the body. It is given before the surgery to reduce the size of tumours and make them easier for surgical removal, or given after the surgery to kill cancer cells that remain. Chemotherapy is usually given in cycles, with each cycle consisting of a fixed number of days of treatment, followed by a period of rest for the body to recover. The number of cycles and the length of treatment will vary based on the individual’s case. Chemotherapy is available in the form of pills to take orally and as an infusion to receive intravenously. Overall, chemotherapy is an important part of male breast cancer treatment and patients can undergo chemotherapy with proper support and side effects management.

Hormone therapy for Male Breast Cancer

The growth of certain breast cancers can be induced by hormones. Hormones like estrogen, progesterone, and testosterone can promote cancer growth. Your doctor will perform tests to find out if cancer cells have places (receptors) where hormones can attach and make them grow. Only if the tests show positive for such hormone receptors, hormone therapy is recommended. It is given with surgery or radiation therapy to better reduce hormone production or block them from working.

Tamoxifen is a hormone therapy drug to treat estrogen and progesterone receptor-positive breast cancers and idiopathic gynecomastia. It is also recommended for treating metastatic male breast cancer.

Aromatase inhibitors are also approved hormone therapy drugs for treating metastatic male breast cancers. Aromatase is an enzyme that helps convert androgen into estrogen. These drugs block the aromatase from acting on androgen and suppress the levels of estrogen in the body to treat estrogen-receptor-positive breast cancer. Anastrozole, letrozole, and exemestane come under the category of aromatase inhibitors.

Luteinizing hormone-releasing hormone (LHRH) agonist is another best hormone therapy drug for the treatment of metastatic breast cancer in men.

Targeted therapy for Male Breast Cancer

Genetic mutations and high levels of certain proteins are the major causes of breast cancer these days. So, each of the targeted therapy drugs is developed to attack specific types of gene mutations that are driving the growth of cancer cells. Targeted therapy has revolutionized breast cancer treatment, including male breast cancer, and has shown great promise in improving outcomes. These drugs suppress the proteins and block the blood vessels that are supplying these proteins and blood to the tumour. 

There are several types of targeted therapies that are used in the treatment of male breast cancer, including:

HER2-targeted therapy: It is recommended for men with breast cancer that overexpresses the HER2 gene. This works by blocking the signals that promote the growth of these cancer cells. Currently, trastuzumab (Herceptin) is the only HER2- targeted therapy drug available, but the information is limited and its efficacy in male breast cancer treatment is still under clinical evaluation.

PARP inhibitors: PARP inhibitors are a newer type of targeted therapy that blocks the PARP proteins leading to the death of cancer cells. This type of therapy works effectively for male breast cancer that has BRCA gene mutations.

Targeted therapy may be inappropriate for all men with breast cancer. Your healthcare team will determine if targeted therapy is the best for your condition.

Combination of any of these therapies

Often doctors prescribe combination therapies to treat breast cancer more effectively. If you or your doctor feel that none of the existing treatments is working for your breast cancer, your doctor may advise you to go for clinical trials.

Every treatment can cause side effects like nausea, vomiting, diarrhoea, fatigue, skin irritation, etc. Your treating team will prescribe medications to deal with any side effects afterwards. If you face any unusual symptoms that persist or worsen, consult your doctor and seek necessary medical help.

Can Male Breast Cancer be Inherited?

Just like in women, certain genetic mutations can increase a man’s risk of developing breast cancer, but it is rare. The most well-known mutations are BRCA1 and BRCA2 which are responsible for many inherited breast cancers. If a man has a family history of breast cancer, particularly in close relatives, it is worth considering genetic testing to detect if he has mutations. This information can help him make informed decisions about his health and treatment options. However, a family history does not necessarily mean that a man will develop breast cancer. There are cases where a man has been affected with breast cancer without any known family history. This may be due to acquired mutations from lifestyle risk factors.

It is also advised to go for screening in case of a family history of breast cancer. Talk to your doctor to get the proper screening test. This helps identify if you are at risk of breast cancer and also detects breast cancer in its early stages.

What Will be the Survival Rate of Men with Breast Cancer?

The survival rate for men with breast cancer varies and depends on a number of factors, such as the type and stage of the cancer, the size of the tumour, the type of treatment received, and the patient’s overall health.

In general, the 5-year relative survival rate for men with breast cancer is about 80%. This means that about 80% of men with breast cancer are expected to live for at least 5 years after their diagnosis. Please note that survival rates are an estimate based on a large group of population and may not accurately define the outcome for an individual patient.

It is also important to note that early detection and prompt treatment can greatly improve the chances of a successful outcome. If you have a suspicion of breast cancer risk, seek medical attention as soon as possible. With the right care and support, many men with breast cancer are able to successfully manage their condition and achieve a good quality of life.

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